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The Surgical outcomes of fundus-first technique in lowering the rate of bile duct injuries and bleeding during open cholecystectomy that facing intraoperative difficulties: A single-center prospective study: The surgical outcomes of open fundus-first cholecystectomy technique.
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Background: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.

Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underwent elective open fundus-first cholecystectomy for intraoperative difficulties.

Results: the majority of cases had long-standing cholelithiasis with intraoperative difficulties revealed by pre-operative TUS and MRCP which required open fundus-first cholecystectomy in 173 (68.4%) of patients, (P-value <0.05). The operative surgical time was 120 minutes in 103 patients (40.7%), (P-value <0.05). During open cholecystectomy, variable intraoperative difficulties were found in all patients, (P-value <0.05) and were divided into: (A) Contracted intra-hepatic gallbladder seen in 157 (62.1%) of cases; (B) Distorted anatomy within Calot's triangle seen in 135 (53.4%) of patients; and (C) Intraoperative bleeding from the liver bed was observed as bloody oozing form in 150 (59.3%) of cases. Our patients had minimal postoperative complications like mild wound infection in 8 (3.2%) of cases and mortality rate was zero. 

Conclusions: There is a need for appropriate therapeutic and preventive strategies in healthcare systems for safe dealing with difficult cholecystectomy. Unclear anatomy due to severe inflammatory dense adhesions at Calot’s triangle and CBD stones needing difficult surgeries are the most important limiting factors for fundus-first laparoscopic cholecystectomy. Hence, we humbly recommend an open approach of fundus-first cholecystectomy as safe surgical option to reduce the incidence of bile duct injuries and intra-operative bleeding.

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Publication Date
Thu May 15 2025
Journal Name
Journal Of Legal And Political Studies
International and Regional Competition in the Middle East and its Impact on Iraqi National Security, with Special Reference to the Kurdistan Region: A Study of Challenges and Opportunities
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This competition between competing forces, organized into axes with conflicting objectives, is reflected in all regional affairs and the goals and interests of countries within them, including Iraq. Among the most important aspects impacted by the repercussions of international and regional competition in the region is Iraqi national security, based on its vital importance in preserving the sovereignty and entity of the Iraqi state, protecting the interests and cohesion of the state and people, ensuring and defending their present and future, and interacting with various regional and international activities. The Kurdistan Region, as an important part of Iraq with its own unique characteristics, may be one of the most important regi

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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi Journal Of Science
Assessing the Potentiality of Using CXCL9 as A Predictive Biomarker for Acute and Chronic Toxoplasmosis, and Study the Correlation Between CXCL9, Toxoplasmosis and Thyroid Disorder in These Cases
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     Background:  Chemokine (C-X-C motif) ligand (CXCL9) has an important role recruiting the T-lymphocytes and immune response after infection by inducing T-cells accumulation around the areas associated with infections. However, this role is poorly known in relation with Toxoplasma gondii infection and also in association with thyroid hormones, which the present study is focused on. Methods: Eighty-seven women were included in this study for the period between September 2021 and February 2022. Blood samples of uninfected healthy pregnant, in addition to aborted and pregnant women infected with toxoplasmosis, were collected. Sera were then obtained and stored at -10°C. Toxo-latex agglutination test was done, followed by detec

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Publication Date
Sun Apr 30 2017
Journal Name
Journal Of Engineering
Experimental Study on Heat Transfer and Friction Factor Characteristics of Single Layer Graphene Based DI-water Nanofluid in a Circular Tube under Laminar Flow and Different Heat Fluxes as Boundary Conditions
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An experimental study was performed to estimate the forced convection heat transfer performance and the pressure drop of a single layer graphene (GNPs) based DI-water nanofluid in a circular tube under a laminar flow and a uniform heat flux boundary conditions. The viscosity and thermal conductivity of nanofluid at weight concentrations of (0.1 to 1 wt%) were measured. The effects of the velocity of flow, heat flux and nanoparticle weight concentrations on the  enhancement of the heat transfer are examined. The Nusselt number of the GNPs nanofluid was enhanced as the heat flux and the velocity of flow rate  increased, and the maximum Nusselt number  ratio (Nu nanofluid/ Nu base fluid)   and thermal performance factor

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Future trends of the insurance sector in the integration of public insurance companies in Iraq And its impact on the quality of insurance service: Applied Study in the Iraqi General Insurance Company and the National Insurance Company
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     This study research to Showing The impact of the integration process on the quality of Insurance service and analyze the impact financially to determine whether there is any impact on the quality of the insurance service, in addition to identifying the obstacles that impede the merger between the insurance companies, insurance and the appropriate proposals for its' application and benefit from the benefits achieved.

The importance of The study lies in the fact that it is an important and vital spotlight that is becoming increasingly important in the world to confront the various difficulties and crises that have occurred  recently in light of the liberalization of international trade, globalization a

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Dermatology & Dermatologic Surgery
Treatment of cutaneous leishmaniasis by topical 25% podophyllin solution (single, blinded, therapeutic, controlled study)
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KE Sharquie, AA Noaimi, AG Al-Ghazzi, Journal of Dermatology & Dermatologic Surgery, 2015 - Cited by 19

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Publication Date
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
Core competencies and Their Role in Enhancing Organizational flexibility: An Analytical Study of the Views of a Sample of Employees in Presidency University of Mosul
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Abstract

The study aims to identify the levels of core competencies dimensions and types of organizational flexibility in the investigated organization, as well as to determine the nature of the relationship and the impact of core competencies dimensions with the process of organizational flexibility. Thus, a number of research questions were presented to express the research problem as follows:

  • What is the level of the investigated individuals' awareness to core competencies and organizational flexibility across their dimensions and types in the investigated organization?
  • To what extent are core competencies and organizational flexibility available in the Organiz

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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of Engineering
Comparative Biosorption Of Pb(II), Cr(III) AND Cd(II) Ions In Single Component System By Live And Dead Anaerobic Biomass, Bath Study
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In this study, dead and live anaerobic biomass was used in biosorption of Pb(II), Cr(III) and Cd(II) ions from a synthetic wastewater. The biosorption was investigated by batch adsorption experiments. It was found that, the biosorption capacities were significantly affected by biosorbent dosage. The process follows Langmuir isotherm (regression coefficient 0.995, 0.99 and 0.987 for Pb(II), Cr(III) and Cd(II) ions, respectively, onto dead anaerobic biomass) model with uniform distribution over the biomass surface. The experimental uptake capacity was 51.56, 29.2 and 28 mg/g for Pb(II), Cr(III) and Cd(II), respectively, onto dead anaerobic biomass, compared with 35, 13.6 and 11.8 mg/g for Pb(II), Cr(III) and Cd(II), respectively, onto live

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Publication Date
Sat Jul 19 2025
Journal Name
Journal Of Pharmacology And Pharmacotherapeutics
Pharmaceutical Frontliners: Community Pharmacists’ Contribution to Managing Medication Needs During a Health Crisis— The COVID-19 Era as an Example
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Community pharmacists faced more complex challenges in meeting patients’ medication needs during the pandemic than previously reported in the literature. Objectives To explore the perception and abilities of community pharmacists in managing patients’ needs in terms of medication dispensing during the pandemic, and to examine its effect on improving the patients’ situations. Materials and Methods A cross-sectional study design, validated by 30 experts, was conducted using an electronic survey (Google Form) to assess the effect of the dispensing practice of Iraqi community pharmacists on the patient’s clinical outcomes during the pandemic. The survey was distributed on professional pharmacist’s social media platforms from December

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
The Services in Central Library of Salah Eldeen University and The Attitude to Computerize (Cause Study)
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The aim object of research is to show the computerized services library of Salahaldeen University in Erbil city in Iraq, so the research treatment all side of library such as building, location ,staff ,finance, resource collection and services ,we refer to. problem which face library such as administration and finance through the using Of case study method, reference source ,meeting , online comment and data record .The study focus develop in library departments, users services, management ,staff, the resource collection, building and location.
The study ending with many results and recommendation to develop the library services by using modern Information system to all users inside and outside the university and link them with other

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Publication Date
Tue Mar 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Performance evaluation criteria"Applied Study in the General Company for the manufacture of glass and ceramics"
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Contemporary management is interested in the process of performance assessment  because of its significance in the field of planning and controlling the multiactiveties to attain its goals and uncovering digression of virtual performance after comparing it with the plan or equitable performance.

Digression is analyzed to enable management control centers of authority.

Assessment process significance is closely related by setting definite categories to evaluate the economic activity to know the ability to achieves aims.

This study concentrated on the most important categories that used to evaluate  company understudy with ather categories suggested to complete assessment process.

This study is in

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